Disseminated tumour cells from the bone marrow of early breast cancer patients: Results from an international pooled analysis

Hartkopf AD, Brucker SY, Taran FA, Harbeck N, von Au A, Naume B, Pierga JY, Hoffmann O, Beckmann M, Rydén L, Fehm T, Aft R, Solà M, Walter V, Rack B, Schuetz F, Borgen E, Ta MH, Bittner AK, Fasching P, Fernö M, Krawczyk N, Weilbaecher K, Margelí M, Hahn M, Jueckstock J, Domschke C, Bidard FC, Kasimir-Bauer S, Schoenfisch B, Kurt AG, Wallwiener M, Gebauer G, Klein CA, Wallwiener D, Janni W, Pantel K (2021)

Publication Type: Journal article

Publication year: 2021

Journal

European Journal of Cancer Elsevier

Book Volume: 154

Pages Range: 128-137

DOI: 10.1016/j.ejca.2021.06.028

Abstract

Purpose: Presence of disseminated tumour cells (DTCs) in the bone marrow (BM) has been described as a surrogate of residual disease in patients with early breast cancer (EBC). PADDY (Pooled Analysis of DTC Detection in Early Breast Cancer) is a large international analysis of pooled data that aimed to assess the prognostic impact of DTCs in patients with EBC. Experimental design: Individual patient data were collected from 11 centres. Patients with EBC and available follow-up data in whom BM sampling was performed at the time of primary diagnosis before receiving any anticancer treatment were eligible. DTCs were identified by antibody staining against epithelial cytokeratins. Multivariate Cox regression was used to compare the survival of DTC-positive versus DTC-negative patients. Results: In total, 10,307 patients were included. Of these, 2814 (27.3%) were DTC-positive. DTC detection was associated with higher tumour grade, larger tumour size, nodal positivity, oestrogen receptor and progesterone receptor negativity, and HER2 positivity (all p < 0.001). Multivariate analyses showed that DTC detection was an independent prognostic marker for overall survival, disease-free survival and distant disease-free survival with hazard ratios (HR) and 95% confidence intervals (CI) of 1.23 (95% CI: 1.06–1.43, p = 0.006), 1.30 (95% CI: 1.12–1.52, p < 0.001) and 1.30 (95% CI: 1.08–1.56, p = 0.006), respectively. There was no association between locoregional relapse-free survival and DTC detection (HR 1.21; 95% CI 0.68–2.16; p = 0.512). Conclusions: DTCs in the BM represent an independent prognostic marker in patients with EBC. The heterogeneous metastasis-initiating potential of DTCs is consistent with the concept of cancer dormancy.

Authors with CRIS profile

Matthias Beckmann Lehrstuhl für Geburtshilfe und Frauenheilkunde Peter Fasching Professur für Translationale Frauenheilkunde und Geburtshilfe

Involved external institutions

Eberhard Karls Universität Tübingen DE Germany (DE) Ludwig-Maximilians-Universität (LMU) DE Germany (DE) Universitätsklinikum Heidelberg DE Germany (DE) Oslo University Hospital / Oslo Universitetssykehus Rikshospitalet NO Norway (NO) Institut Curie FR France (FR) Universitätsklinikum Essen DE Germany (DE) Lund University / Lunds universitet SE Sweden (SE) Heinrich-Heine-Universität Düsseldorf DE Germany (DE) Washington University US United States (USA) (US) Health Sciences Research Institute of the “Germans Trias i Pujol” Foundation (IGTP) ES Spain (ES) Universitätsklinikum Ulm DE Germany (DE) Catalan Institute of Oncology / Institut Català d'Oncologia (ICO) ES Spain (ES) Asklepios Kliniken DE Germany (DE) Universitätsklinikum Hamburg-Eppendorf (UKE) DE Germany (DE) Universität Regensburg DE Germany (DE)

How to cite

APA:

Hartkopf, A.D., Brucker, S.Y., Taran, F.A., Harbeck, N., von Au, A., Naume, B.,... Pantel, K. (2021). Disseminated tumour cells from the bone marrow of early breast cancer patients: Results from an international pooled analysis. European Journal of Cancer, 154, 128-137. https://doi.org/10.1016/j.ejca.2021.06.028

MLA:

Hartkopf, Andreas D., et al. "Disseminated tumour cells from the bone marrow of early breast cancer patients: Results from an international pooled analysis." European Journal of Cancer 154 (2021): 128-137.

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